| Dr Matthew David Phillips, MD | |
|
1950 N Harlem Ave, Elmwood Park, IL 60707-3717 | |
| (708) 453-6800 | |
| (708) 453-3235 |
| Full Name | Dr Matthew David Phillips |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 1950 N Harlem Ave, Elmwood Park, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962066597 | NPI | - | NPPES |
| 36171243 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 036171243 (Illinois) | Primary |
| Entity Name | Tiesenga Surgical Associates Sc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801876586 PECOS PAC ID: 5597750901 Enrollment ID: O20040420001105 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Matthew David Phillips, MD 1950 N Harlem Ave, Elmwood Park, IL 60707-3717 Ph: (708) 453-6800 | Dr Matthew David Phillips, MD 1950 N Harlem Ave, Elmwood Park, IL 60707-3717 Ph: (708) 453-6800 |
Charles Bradley Schubert, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1950 N Harlem Ave, Elmwood Park, IL 60707 Phone: 708-453-6800 Fax: 708-453-3235 | |
Mrs. Deepa Cherla Patel, MD Surgery Medicare: Medicare Enrolled Practice Location: 1950 N Harlem Ave, Elmwood Park, IL 60707 Phone: 908-227-4052 | |
Henry Robert Govekar, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1950 N Harlem Ave, Elmwood Park, IL 60707 Phone: 708-453-6800 Fax: 708-453-3985 | |
Athanasios D. Diniotis, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1950 N Harlem Ave, Elmwood Park, IL 60707 Phone: 708-453-6800 Fax: 708-453-3235 | |
Timothy Jordan Stear, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1950 N Harlem Ave, Elmwood Park, IL 60707 Phone: 708-453-6800 Fax: 708-453-3985 | |
Alexander Knijnikov, D.O. Surgery Medicare: Accepting Medicare Assignments Practice Location: 1950 N. Harlem Ave., Suburban Surgery Center, Elmwood Park, IL 60707 Phone: 708-453-6800 Fax: 708-453-3985 | |
Frederick M Tiesenga, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 1950 N Harlem Ave, Elmwood Park, IL 60707 Phone: 708-453-6800 Fax: 708-453-3235 |